In Michigan County, incentive funds are redesigning public health programs

LANCING, Michigan – A health clinic with nearly $ 900,000 in federal pandemic relief funds is being built in an underserved neighborhood in the Michigan capital, a project that could change the community’s access to care.

Locked among new affordable apartments and a community center, the clinic is a symbol of the rapid impact the funds have on many local public health programs.

In Michigan and some other states, stimulus aid to cities and counties is being used faster than billions in certain state funds, some of which remain tied to the legislature at a dead end on how to spend it. And while much of local aid is moving to other priorities, many cities and counties say rescue funds have provided an opportunity to improve chronically underfunded public health systems as they recover from the pandemic by tackling the established health disparities that Covid -19 worse.

Here, in mid-Michigan, where officials warn of rising levels of violence, drug addiction and delayed care during the pandemic, local aid from last year’s stimulus bill, the U.S. Rescue Plan, rewrote Ingham County’s economic condition and its public health programs – at least for now.

Of the $ 350 billion for states and settlements in the rescue plan, $ 195 billion went to state governments, and another $ 130 billion went to cities, counties and other local governments, many of which predicted huge revenue losses at the start of the pandemic. Local authorities have been given a wide margin of appreciation on how to spend the money, and many use at least some of it to support public health.

Nearly $ 60 million was sent to Ingham County, home to nearly 300,000 people in Lansing and its suburban and rural areas. Local officials worked quickly last year to use an initial $ 28 million tranche and are ready to start implementing another $ 28 million that will arrive this spring, some of which could be spent on an ambitious series of public health proposals.

“We have connections in the community and we know where to go quickly,” said Greg Todd, the county superintendent.

The Ingham Ministry of Health has asked for money to replace septic systems on the county’s rural outskirts; hire a nurse and more health care providers for the new clinic and a separate addiction clinic; renewal of public dental practice; and launch a harm reduction program aimed at reducing the transmission of HIV and viral hepatitis. For now, the county plans to use the rescue money to fund the septic program, Mr Todd said.

Nowhere is the effect of the money clearer than the new clinic, Allen Neighborhood Municipal Health Center, which will join a network of public health centers that serve tens of thousands of patients each year. Linda Vale, Ingham County Public Health Officer, said her department had planned to open a bare bone clinic and recruit staff from other community clinics before the stimulus funds arrived, “robbing Peter of paying Paul.” “. Funding for the incentive, $ 750,000 to build the clinic and $ 137,956 to hire staff, allowed the county to repeal the plan and speed up the schedule.

The county hopes to open the clinic by the summer and begin serving up to two dozen patients a day.

Nearly two miles from the Capitol, lawmakers in the Republican-controlled legislature have yet to allocate billions of US rescue plan funds to what some state Democrats have described as an attempt to stifle Governor Gretchen’s agenda. Whitmer, Democrat. Congress last month considered reimbursing unspent state funds, including from Michigan, howling on both sides.

Curtis Hertel Jr., a Sen. Democrat from Ingham County, said the county’s rapid use of its stimulus funds was a good counterexample to the U.S. legislature’s grip on the bigger pot of money it said it could now. to have a significant impact more of it were released quickly.

“Michigan has a mental health disorder,” he said. “We could have saved more lives in Michigan.”

Local officials have until 2026 to spend the money from the US rescue plan. In some communities, money is just beginning to flow. Everywhere, stimulus funds are a litmus test for local priorities.

The first tranche of $ 28 million in Ingham County went not only to public health initiatives, but also to infrastructure projects and hundreds of local businesses. One million dollars was spent on emergency medical equipment, including new ambulances and training. The county also spent $ 150,000 on repairing public storm canals and $ 450,000 on hiring more behavioral health professionals in a local mental health program with a focus on adolescent mental health.

Resources extend far beyond public health. More than $ 8 million in small business grants have helped curb some of Lansing’s trade downturn during the pandemic. Nicki Thompson Fraser, who owns the Sweet Encounter bakery and café in downtown Lansing, said her $ 5,000 grant allowed her to buy more mixers, produce more pastries and hold more baking classes. The money has grown, she said, which has allowed her to hire two workers.

“Sometimes you just need a little push,” she said.

The Allen Clinic employs a small staff that hopes to gradually expand if more funding materializes: two reception staff, a nurse, two nurses, a behavioral health specialist and a medical assistant. Local authorities hope to eventually hire a doctor and another medical assistant.

The clinic will have a pharmacy that provides free or cheap prescriptions to its patients, and a blood collection laboratory.

The neighborhood that will serve the clinic has more than 17,000 residents and is approximately 20 percent black, 12 percent Spaniard, 60 percent white and 3 percent Asian, according to Joan Nelson, who runs a community center next to the future health clinic. Approximately 25 percent of the community lives below the poverty line, and 20 percent of families do not own cars, she said. A new bus stop outside the center was recently added to help patients reach the clinic.

Dr. Adenike Shoinka, medical director of the county health department, called the investment in the Alan complex a “template” for redesigning public health programs in Lansing.

The Chitalishte next to it includes a food pantry that distributes over £ 1,000 of baked goods and produce each week and has a year-round farmers market, gardening classes and a community-sponsored farming program. The center also enrolls low-income residents in Medicaid coverage and the Affordable Care Act. But Ms Nelson said her staff often have to refer people to distant public clinics, a position they will no longer be in once the clinic opens next door.

Ms. Vail, a county health official, said the influx of stimulus money has helped renew the focus on primary care in the area. It serves a different purpose than vaccines, tests, treatments and personal protective equipment, she said, but it is just as important.

“It takes investment and money to recover from a pandemic, not just respond to a pandemic,” she said.

The new resources, Ms. Vail added, could help reverse a decline in faith in local public health departments, some of which are working to restore their reputations after being targeted by people angry at the pandemic’s restrictions.

“I think we have a lot of work to do to regain our trust,” she said. “Unless people trust us, then they will not continue to come to us for all the things we can provide,” including immunizations, nursing programs that prevent mothers from losing their babies before they do. “re a year old” and the food aid program for women, babies and children, known as WIC.

United States spokeswoman Elisa Slotkin, a Democrat whose district includes Ingham County, recently traveled to Lansing to announce a federal-led project that will add social workers to Lansing Police Department for mental health calls.

Ms. Slotkin said she was concerned that the benefits of federal aid to stimulate Covid-19 could be fleeting in a state where some counties have only one public health officer.

“The entire health care system is backed by Covid’s money,” she said in an interview, referring to stimulus funds transferred from the Trump and Biden administrations. “What will they do to take some of these temporary gains and turn them into a strategic change in public health and mental health?”

The next day, a few miles north at another community health center, staff prepared strips of Suboxone, a drug that can help quit opioid users, part of a program aimed at tackling a growing fentanyl crisis in Lansing.

The clinic, which treats homeless people at a neighboring shelter, is still looking to hire more suppliers. More money is needed for a new project to reduce overdoses and deaths that increased during the pandemic, Ms Vale said.

Further south, at Forest Community Health Center, a federal incentive can be used to upgrade dental practice facilities, which are in high demand. In a refugee resettlement city, the clinic treats thousands of refugees each year, including more than 300 who have recently arrived from Afghanistan.

Initially, federal relief was a challenge for the clinic to use quickly, said Isabella Wakowski-Norris, who is monitoring it. But federal and local aid eventually helped the clinic afford protective equipment, an external passage structure and telehealth software, among other resources.

Ms. Wakowski-Norris said she hoped to hire a psychiatrist and nutritionist soon and build the clinic’s HIV treatment program.

“We are here and we are doing the best we can,” she added. “But we just can’t do everything we want because we’re not made of money.”

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